‘Losing my mind'. 'Going crazy'. 'Feeling hysterical.’ These are all disparaging terms for feeling overwhelmed by anxiety, intense states of panic or dissociation.

In a crisis, or in a tight spot under pressure, many of us may feel we’re going out of our minds. It's almost as if we’ve been cut adrift from the world. At this point, you may experience becoming excessively sensitive, distressed or bombarded with hair-trigger sensations – such as shortness of breath or heart-rate pounding. You may feel disembodied as you become detached from yourself and go numb or shut down. You may even feel light-headed – as if you’re in the room but not quite present. And everything goes a little abstract.

In psychotherapy both these states are commonly known as hyperarousal and dissociation respectively.

It is a much more common experience than you might think, even among people who appear superficially in control of their lives. Losing your mind may be experienced as extreme confusion, distress and/or dissociation from oneself. It may be so overwhelming that it leads to anxiety and panic attacks. You are not alone, and it is highly unlikely that you’re actually losing your mind.

Days after a period of dissociation or panic attack, you might be plagued with excessive worrying or being preoccupied with thoughts of impending disaster, and even feel a compulsive need to screenplay events in your head. Over and over again. You may become so lost in your thoughts that you cannot find relief until you’re completely exhausted. As the panic sets in it feels like a slow impending disaster is drawing in which cannot be avoided. This can also be accompanied by a constant running commentary in your head or a highly critical internal dialogue with yourself – you may feel weak, helpless and ashamed. These are some of the symptoms below:

Symptoms of hyperarousal or hypervigilance:

hair-trigger emotions, fear or panic

breathlessness, heart palpitations or racing

a sense of being overly vigilant, jumpy or easily startled

headaches, knotted stomach, butterflies or acid reflux

excessive sensitivity to noise and light,

high tension in the back, neck and shoulders

trembling, shaking, sweating

a constant sense of foreboding

avoidance strategies.

Symptoms of dissociation:

going numb or blank

extreme panic or feeling overwhelmed

disembodied or disconnected from oneself

incessant worrying or screen-playing in your head

dissociative states or detachment from others

emotional withdrawal or shut down

not feeling grounded

feeling abandoned

cut adrift.

So, if you're not losing your mind, what is it and what can you do about?

The emotional states above are often triggered by extreme distress, anxiety, bereavement or traumatic events. Sometimes they can simply be due to an accumulation of stress over a long period of time. You may not even notice the symptoms at first or try to ignore them. What you need to do is find a way of slowing down, grounding yourself, building up your awareness of internal states and regulating your emotions. You may need to develop ways of developing mindfulness routine that bring calm and relief, as well as stretching, exercising and discharging the hormones that cause you high anxiety.

Slowing down and awareness

Sit down, pause and do nothing for a few seconds. Slowly turn your attention to your bodily sensations – breathing, heart-rate, movements. Focus your awareness on the rhythm and sensation of your breathing. Breathe from you diaphragm more slowly and deeply than before. Observe and listen to your body as it slows down, giving you a gap…not to think, not to reflect, not do anything but enjoy the seamless flow of your consciousness. If there’s a mindless chatter in your brain, slow it down. If you mind wanders, bring it back to your breath. If you have an endless train of thoughts, slowly acknowledge their presence and let them go.

Grounding techniques

The idea of this exercise is to feel stable, strong and well-balanced in yourself, bringing you out of disembodied or dissociative states. By anchoring your feet and body to the floor you can feel held and well-supported by being in your own body. You can do this exercise sitting or standing. Put your feet flat on the floor and spread your legs until you feel balanced and fully stable. For awhile you can bounce on your heels and dig them into the floor or sway your hips as if skiing or surfing until you find your centre of gravity. Then drop your hips and shoulders lightly until you feel firmly attached to the ground. It may also help to grip something in your hands. Or push against a wall until you feel your own strength, power and stability.

Regulating emotions

You can regulate you emotional states simply by body scanning, breathing mindfully and becoming more accepting of intense emotions by observing them in the moment as they emerge, change and fluctuate. This takes time and patience, as you will often struggle not to become deeply engaged in you emotional drama. But you need to realise that the anticipated catastrophes you imagine in a state of anxiety are not happening right now. Come to realise that you are not your emotions or the events you inhabit. Your emotions will come and go, ebb and flow and fluctuate in intensity. But although you feel distressed, your emotions cannot harm you. They are just signals of a perceived or real threat. You can regulate your emotions with breathing, stretching, exercise fluid movement, yoga and meditating on natural sounds and sensations. You do not have to fall into the grip of your emotions – just pause, step back and allow them to settle. Even in the midst of a panic attack you can slowly learn to observe your feelings and regulate them; as you release yourself from the drama and let the intense feelings unfold, riding them awhile before intervening and stepping in to slow them down. The point of regulating emotions is not to create a continuous state of calm, but simply a sense of balance between negative and positive feelings.

Discharging stress hormones

It is also important to realise that stress is created by hormones and neurochemical transmitters in the body, not just the brain. We need to learn to listen to the body, our sensations and emotional states so that we can also discharge the powerful chemicals that disrupt our well-being and embodied consciousness. We can use stretching, yoga, saunas, massage and hold-and-cold treatments to release tension we hold in our neck back and shoulders. This releases lactic acid from the muscles, tendons and ligaments, which may also have become tight and foreshortened. We can use walking meditations, swimming, dance, running and exercise in natural environments to create sensations of movement, fluidity and attuning to our environment so that we learn to trust our instincts and bodies to support us. Singing and chanting can lend us sensations of being open, relaxed and expansive.

Of course, all of this can be learned through a process of engagement with a counsellor who understands sensorimotor processes, neuroscience and mindfulness practice.

I am Greg Savva. An experienced counsellor at Counselling Twickenham, EnduringMind. I believe in a compassionate, open-minded approach to counselling as the best way forward for my clients. I focus on helping you make sense of erratic thoughts and emotions. Offering you a chance to gain self-awareness and change for the better.